Feasibility of single-session endoscopic combined intrarenal surgery for ipsilateral large renal stones and retrograde intrarenal surgery for contralateral renal stones: Initial experience.

OBJECTIVES

To analyze the feasibility of carrying out endoscopic combined intrarenal surgery with supine miniaturized percutaneous nephrolithotomy and retrograde intrarenal surgery for patients with bilateral stones in a single session.

METHODS

The records of consecutive patients presenting with bilateral kidney stones who underwent endoscopic combined intrarenal surgery with miniaturized percutaneous nephrolithotomy (15-Fr miniaturized nephroscope) and retrograde intrarenal surgery on one side, and retrograde intrarenal surgery on the contralateral side were prospectively collected and analyzed. After the miniaturized percutaneous nephrolithotomy procedure, flexible uretero-renoscopy was carried out for active removal of the stone fragments. Subsequently, retrograde intrarenal surgery was carried out on the contralateral side.

RESULTS

Overall, 26 patients were included in the analysis. The stone-free rate of the initial endoscopic combined intrarenal surgery side was 76.9% (20/26), and the stone-free rate of the contralateral retrograde intrarenal surgery side was 92.3% (24/26). Complications occurred in two patients (postoperative bleeding and urinary tract infection); however, these conditions were completely resolved with appropriate medications within 2 weeks postoperatively. Univariate logistic regression analyses showed that accumulation of surgical experience (OR 117.3, P = 0.046) was a significant predictor for stone-free status.

CONCLUSION

Carrying out endoscopic combined intrarenal surgery and contralateral retrograde intrarenal surgery in a single session for patients with bilateral stones is feasible and safe.